Early aneurysm formation following anterior mycardial infarction: A better predictor of mortality than left ventricular ejection fraction
To compare the prognostic effect of aneurysmal infarct expansion (AN) to ejection fraction (EF), 52 consecutive high risk patients (pts) with initial anterior transmural myocardial infarction (MI) underwent 4-view bedside multigated cardiac blood pool imaging within 48 hours of chest pain and prehospital discharge. AN was strictly defined as an akinetic or diskinetic portion of the left ventricle which had diastolic deformity and was adjacent to areas with normal motion. EF < 35% was found to be the best EF cut-off for testing prediction of mortality. One year follow-up was performed by telephone interview (14 months, range 6-21). AN developed in 18/52 pts (35%), 9 developed by 48 hours and 9 further predischarge. 35/52 patients (69%) had EF < 35%. One year mortality was 27% (14/52). AN was highly predictive of death: 11/18 pts with AN died, while only 3/34 without AN died (chi/sup 2/ = 16.35, rho <.001). This was independent of EF: EF did not differ between pts with and without AN (27.5 +- 8.8 vs 31.5 +- 11.2, rho NS). In contrast EF < 35% was not as useful in predicting mortality; 12/35 pts with EF < 35% died while 2/17 with EF greater than or equal to 35% (chi/sup 2/ = 2.95, rho NS). The presence of AN was equally sensitive (79% vs. 86%) and far more specific (82% vs. 39%) than EF for the prediction of mortality. The authors conclude, AN occurs frequently early following anterior MI and is an important and specific marker for mortality. It is superior to EF as a prognostic indicator in this high risk subset of pts and therefore may be a useful parameter in stratification of pts in trials designed to reduce mortality.
- Research Organization:
- Yale Univ., New Haven, CT
- OSTI ID:
- 6572869
- Report Number(s):
- CONF-840619-; TRN: 87-019062
- Journal Information:
- J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
- Country of Publication:
- United States
- Language:
- English
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